Stigma Perceived and Experienced by Adults with Type 1 Diabetes: Linguistic Adaptation and Psychometric Validation of the Danish Version of the Type 1 Diabetes Stigma Assessment Scale (DSAS-1 DK)

Ulla Møller Hansen (), Ingrid Willaing, Adriana D. Ventura, Kasper Olesen, Jane Speight and Jessica L. Browne
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Ulla Møller Hansen: Steno Diabetes Center Copenhagen, Diabetes Management Research
Ingrid Willaing: Steno Diabetes Center Copenhagen, Diabetes Management Research
Adriana D. Ventura: Deakin University
Kasper Olesen: Steno Diabetes Center Copenhagen, Diabetes Management Research
Jane Speight: Deakin University
Jessica L. Browne: Deakin University

The Patient: Patient-Centered Outcomes Research, 2018, vol. 11, issue 4, No 4, 403-412

Abstract: Abstract Objectives We aimed to (a) culturally and linguistically adapt the Type 1 Diabetes Stigma Assessment Scale (DSAS-1) from English (for Australia) into Danish and (b) examine psychometric properties of the measure among Danish adults with type 1 diabetes. Methods We performed a forward–backward translation, face validity interviews with experts and cognitive debriefing of the Danish version (DSAS-1 DK) with ten adults from the target group. The DSAS-1 DK was then completed by 1594 adults with type 1 diabetes. Electronic clinical records provided age, diabetes duration, diabetes-related complications, and glycemic control [glycated hemoglobin (HbA1c)]. We examined internal consistency, construct validity and structural validity of the DSAS-1 DK using exploratory and confirmatory factor analysis in a cross-validation design. Results The translated measure was found acceptable by the experts and target group, with only minor adaptations required for the Danish context. The DSAS-1 DK structure was best represented by a three-factor model representing the subscales ‘Treated Differently,’ ‘Blame and Judgement,’ and ‘Identity Concern’ (α = 0.88–0.89). The results also provided some support for calculation of a total score (19-item scale; α = 0.75). The subscales and total scale demonstrated satisfactory convergent and discriminant validity. Good structural validity was demonstrated for the three-factor model for four out of five indices [normed χ 2 = 4.257, goodness-of-fit index (GFI) = 0.923, root mean square error of approximation (RMSEA) = 0.065, standardized root mean square residual (SRMSR) = 0.0567, comparative fit index (CFI) = 0.93]. Conclusion The DSAS-1 DK has a confirmed three-factor structure, consistent with the original Australian English version. The measure is now validated and available to advance research into the stigma perceived and experienced by adults with type 1 diabetes in a Danish context.

Date: 2018
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DOI: 10.1007/s40271-017-0289-x

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